LDH inhibitors block lactate production, but some compounds actually help with lactate clearance and utilization (moving it into mitochondria, converting it back to pyruvate, or buffering/removing it).
Lactate Clearing Compounds — Reference Table
Compounds and strategies reported to enhance lactate clearance, buffering, or utilization. Includes drugs, nutrients, and natural agents.
| Category | Substance | Mechanism for Lactate Clearance | Best Taken With | Timing Consideration | Evidence Rank |
|---|---|---|---|---|---|
| Drug / Metabolic | Dichloroacetate (DCA) | Activates PDH, channels pyruvate into mitochondria → lowers lactate accumulation. | Water; often combined with thiamine support | Morning or early afternoon (peak mitochondrial activity) | ++ |
| Drug / Metabolic | Meldonium (Mildronate) | Modulates carnitine metabolism, promoting lactate utilization as an energy substrate. | With water | Morning; avoid evening (can be stimulating) | ++ |
| Nutrient | L-Carnitine | Supports mitochondrial uptake and oxidation of lactate as fuel. | With meal or fat | Morning or pre-exercise | ++ |
| Nutrient | Creatine | Enhances phosphocreatine buffering → indirectly lowers lactate buildup. | With carbohydrate or amino acids | Morning or post-exercise | ++ |
| Buffering Agent | Sodium Bicarbonate | Alkaline buffer, enhances blood lactate clearance capacity. | With water | 60–90 min before exertion / metabolic stress | ++ |
| Mineral | Magnesium | Cofactor for LDH, PDH, and ATPases — supports lactate metabolism efficiency. | With meals | Anytime, consistent intake preferred | + |
| Vitamin | Riboflavin (B2) | Provides FAD for mitochondrial enzymes — assists lactate-to-pyruvate recycling. | With meals | Morning | + |
| Vitamin | Niacinamide (B3) | Boosts NAD⁺ pools, facilitating lactate → pyruvate conversion. | With water | Morning (can interfere with sleep if late) | ++ |
| Coenzyme | Coenzyme Q10 | Improves mitochondrial oxidative phosphorylation, increasing lactate consumption. | With fat | Morning or midday | ++ |
| Coenzyme | Alpha-Lipoic Acid (ALA) | Enhances PDH activity, promotes lactate oxidation in mitochondria. | With meals | Morning or early afternoon | ++ |
| Amino Acid | Glutamine | Can act as a shuttle substrate, assisting in lactate clearance pathways. | With water or light food | Morning or post-exercise | + |
| Plant-Derived | Cordycepin (from Cordyceps) | Reported to improve lactate clearance and endurance in animal studies. | With water | Morning / pre-activity | + |
| Plant-Derived | Rhodiola rosea | Adaptogen; enhances mitochondrial efficiency and lactate clearance in exercise studies. | With water | Morning (mildly stimulating) | ++ |
| Physiological | Exercise / Oxygen Therapy | Increases mitochondrial oxidative capacity, accelerating lactate removal. | Not applicable | During physical activity or oxygenation session | +++ |
Legend — Evidence Rank: +++ = clinical / human data; ++ = strong preclinical or animal + some human evidence; + = cell culture / in vitro or early reports.
✅ Evidence Rank Legend:
- +++ = clinical/human data
- ++ = strong preclinical/animal + some human evidence
- = supportive or indirect evidence